Aneurysm Repair: Two Approaches

An open-chest operation is the traditional surgical treatment for thoracic aortic aneurysms. However, many thoracic aneurysms as well as those that develop in the lower part of the thoracic aorta and the upper part of the abdominal aorta (called thoracoabdominal) can be treated with an endovascular stent graft, a minimally invasive procedure.

Traditional Open Surgery

In traditional surgery, a long incision is made to open the chest. The aorta above and below the weakened area is clamped, and the aneurysm is opened. A tube made of synthetic fabric, called a graft, is sewn inside the aorta to strengthen the area of the aneurysm. The incision in the aorta is then sutured.

The surgery requires general anesthesia followed by several days of recovery in the hospital.

Minimally Invasive Repair

An alternative to open surgery is a minimally invasive procedure called endovascular aneurysm repair. If your abdominal aortic aneurysm has not burst, and the aneurysm is five centimeters (about two inches) or larger, you may be a good candidate for this procedure. Your surgeon will recommend which is best for you.

In endovascular repair, the aortic aneurysm is reached by means of a catheter passed through a blood vessel, instead of through an opening in the chest.

Small incisions are made in the groin to allow the surgeon to insert the catheter and a guide wire and pass them up to the aorta with the aid of X-ray guidance. Through the catheter, a graft made of synthetic fabric and metal stents is placed to reinforce the area of the aneurysm. Once in place, the graft lets blood flow through without strain on the weakened section of aorta.

After endovascular stent grafting, patients usually recover in the hospital for two to three days.

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